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Lee J, Kim J, Valdivia DS. The longitudinal relationship between levels of cognitively stimulating leisure activity and positive and negative affect among older adults with MCI. Psychogeriatrics 2024; 24:369-381. [PMID: 38296267 DOI: 10.1111/psyg.13083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/19/2023] [Accepted: 01/16/2024] [Indexed: 03/04/2024]
Abstract
BACKGROUND The purpose of this study was to investigate the longitudinal relationship between different levels of cognitively stimulating leisure activity (CSLA) participation and different levels of positive and negative affect among older adults with mild cognitive impairment (MCI). METHODS Using a repeated-measured multivariate analysis of covariance (RM-MANCOVA), this study analyzed the Health and Retirement Study (HRS) data from 2012 to 2020 (N = 5932). RESULTS The results presented the following. (a) The high CSLA group showed higher positive affect and lower negative affect than the mid and low groups. Also, the mid-CSLA group presented higher positive affect and lower negative affect than the low CSLA group. (b) Both positive and negative affect showed significant differences between years and indicated a continuously declining slope year by year without exceptions. (c) The high CSLA group not only presented higher positive affect and lower negative affect during the period but also solely showed a rebounding feature in the declining slope on both emotions. CONCLUSIONS The findings of this study provide valuable support for the design and implementation of CSLA participation programs and clinical guidelines for older adults with MCI. The results highlight the importance of determining the optimal level of CSLA engagement that is required to promote emotional health and cognitive function in this population. Healthcare professionals and clinical practitioners can leverage the insights gained from this study to develop and deliver effective CSLA interventions tailored to the specific needs and capacities of older adults with MCI.
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Affiliation(s)
- Jungjoo Lee
- School of Health Professions, College of Nursing and Health Professions, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Junhyoung Kim
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Dubravka Svetina Valdivia
- Department of Counseling and Educational Psychology, School of Education, Indiana University, Bloomington, Indiana, USA
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2
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Zhylkybekova A, Grjibovski AM, Glushkova N, Koshmaganbetova GK. Exploring the burden and support needs of informal caregivers for the older adults in Kazakhstan: a mixed-methods study protocol. Front Public Health 2024; 11:1248104. [PMID: 38249404 PMCID: PMC10796845 DOI: 10.3389/fpubh.2023.1248104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/20/2023] [Indexed: 01/23/2024] Open
Abstract
Background The growing population of older adults, often affected by chronic illnesses, disabilities, or frailty has led to a substantial increase in the need for informal caregivers. Objective This paper is a protocol for a study that aims to investigate the effects of caregiving on informal caregivers of older adults in Kazakhstan with special emphasis on the cultural context. Methods The protocol outlines a mixed-methods study that will be conducted in four cities in Kazakhstan. A total of 400 informal caregivers of older adults with two or more limitations in Activities of Daily Living (ADL) will be recruited to participate in a survey, aiming to evaluate care-related burdens and quality of life and health-related quality of life. The Institute for Medical Technology Assessment (iMTA) Valuation of Informal Care Questionnaire (iVICQ) was selected to be the main research instrument. Additionally, a subset of participants who express their willingness to participate will be selected from the pool of survey respondents to engage in semi-structured interviews, allowing for a deeper understanding of their experiences and providing insights into their social and medical support needs. Conclusion This study will be the first investigation of the impact of caregiving on informal caregivers of older adults in Central Asia. The results will contribute to the literature by providing insights into older adults care within the specific national and cultural context of Kazakhstan with potential generalization to other Central Asian republics of the former USSR.
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Affiliation(s)
- Aliya Zhylkybekova
- Department of Evidence-Based Medicine and Scientific Management, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Andrej M. Grjibovski
- Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russia
- Department of Epidemiology and Modern Vaccination Technologies, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Department of Biology, Ecology and Biotechnology, Northern (Arctic) Federal University, Arkhangelsk, Russia
| | - Natalya Glushkova
- Department of Epidemiology, Biostatistics and Evidence Based Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Gulbakit K. Koshmaganbetova
- Department of Evidence-Based Medicine and Scientific Management, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
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Ahn S, Cobb SJ, Crouter SE, Lee CE, Crane MK, Anderson JG. Physical activity together for couples living with mild cognitive impairment (PAT-MCI): A feasibility study. Geriatr Nurs 2024; 55:221-228. [PMID: 38035459 DOI: 10.1016/j.gerinurse.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023]
Abstract
Mild cognitive impairment is a prodromal phase of Alzheimer's disease and related dementias. Cognitive and/or neuropsychiatric symptoms that could worsen over time cause challenges for patients and romantic partners, who often assume the role of informal caregivers. Although physical activity is beneficial, older adults with mild cognitive impairment and their romantic care partners are generally physically inactive. Our 16-week study was performed to see whether physical activity together is feasible to increase physical activity among four dyads (individuals with mild cognitive impairment and their spouses). Our dyadic intervention was feasible given more than 70 % of participants self-reported adherence to physical activity based on the guidelines for adults in the United States. In exit interviews, togetherness was highlighted as one of the biggest strengths of this study. Future studies with more representative samples are needed, as well as adopting a more tailored approach that accounts for individuals' levels of physical fitness.
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Affiliation(s)
- Sangwoo Ahn
- College of Nursing, University of Tennessee, Knoxville, Tennessee, United States.
| | - Sandra J Cobb
- College of Nursing, University of Tennessee, Knoxville, Tennessee, United States
| | - Scott E Crouter
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, Tennessee, United States
| | - Chung Eun Lee
- Paul H. Chook Department of Information Systems and Statistics, Baruch College, New York, New York, United States
| | - Monica K Crane
- Genesis Neuroscience Clinic, Knoxville, Tennessee, United States
| | - Joel G Anderson
- College of Nursing, University of Tennessee, Knoxville, Tennessee, United States
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Layton N, Lalor A, Slatyer S, Lee DA, Bryant C, Watson M, Khushu A, Burton E, Oliveira D, Brusco NL, Jacinto A, Tiller E, Hill KD. Who cares for the carer? Codesigning a carer health and wellbeing clinic for older care partners of older people in Australia. Health Expect 2023; 26:2644-2654. [PMID: 37680165 PMCID: PMC10632619 DOI: 10.1111/hex.13863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023] Open
Abstract
INTRODUCTION Older carers or 'care partners' of older people experiencing care needs often provide essential support, at times while neglecting their own health and well-being. This is an increasingly frequent scenario due to both demographic changes and policy shifts towards ageing in place. Multiple community stakeholders within the care and support ecosystem hold valuable expertise about the needs of older care partners, and the programme and policy responses that may better support their health and well-being. The aim of this study was to identify the perspectives of stakeholders obtained through the codesign phase of a multicomponent research project investigating new models of care and support for older care partners suitable for the Australian context. METHODS Principles of codesign were used to engage a purposeful sample of older care partners, health professionals, researchers, policy makers and health service administrators. Participants took part in a series of three codesign workshops conducted remotely via video conferencing. The workshops were supported with briefing material and generated consensus-based summaries, arriving at a preferred service model. FINDINGS This paper reports the research design and structure of the codesign panels, the range of findings identified as important to support the health and well-being of older carers of older people, and the resulting service model principles. The codesigned and preferred model of care is currently being prepared for implementation and evaluation in Australia. PUBLIC CONTRIBUTION This study was conducted using codesign methodology, whereby stakeholders including older care partners and others involved in supporting older carers, were integrally involved with design, development, results and conclusions.
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Affiliation(s)
- Natasha Layton
- Rehabilitation, Ageing and Independent Living (RAIL) Research CentreMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingMonash University and Peninsula HealthFrankstonVictoriaAustralia
| | - Aislinn Lalor
- Rehabilitation, Ageing and Independent Living (RAIL) Research CentreMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingMonash University and Peninsula HealthFrankstonVictoriaAustralia
- Department of Occupational Therapy, School of Primary and Allied Health CareMonash UniversityMelbourneVictoriaAustralia
| | - Susan Slatyer
- Centre for Healthy AgeingMurdoch UniversityMurdochWestern AustraliaAustralia
| | - Den‐Ching A Lee
- Rehabilitation, Ageing and Independent Living (RAIL) Research CentreMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingMonash University and Peninsula HealthFrankstonVictoriaAustralia
| | - Christina Bryant
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneVictoriaAustralia
| | - Moira Watson
- Centre for Healthy AgeingMurdoch UniversityMurdochWestern AustraliaAustralia
| | - Anjali Khushu
- Department of Geriatric MedicinePeninsula HealthFrankstonVictoriaAustralia
| | - Elissa Burton
- Curtin School of Allied HealthCurtin UniversityBentleyWestern AustraliaAustralia
- enAble Institute, Faculty of Health SciencesCurtin UniversityBentleyWestern AustraliaAustralia
| | - Déborah Oliveira
- Faculty of Nursing, Universidad Andrés BelloCampus Viña del MarViña del MarChile
- Millennium Institute for Care Research (MICARE)SantiagoChile
| | - Natasha L. Brusco
- Rehabilitation, Ageing and Independent Living (RAIL) Research CentreMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingMonash University and Peninsula HealthFrankstonVictoriaAustralia
| | - Alessandro Jacinto
- Programa de Pós‐Graduação em Medicina Translacional, Faculty of Geriatric MedicineFederal University of São Paulo (UNIFESP)São PauloBrazil
| | - Elizabeth Tiller
- Department of Geriatrics (Falls Prevention Service)Peninsula HealthFrankstonVictoriaAustralia
| | - Keith D. Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research CentreMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingMonash University and Peninsula HealthFrankstonVictoriaAustralia
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Petry H, Ernst J, Naef R. Participatory development and implementation of a dementia care pathway with intervention bundles in acute care during the coronavirus pandemic: A process evaluation study. J Clin Nurs 2023; 32:7193-7208. [PMID: 37317613 DOI: 10.1111/jocn.16799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/13/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023]
Abstract
AIMS To explore the implementation of a dementia care pathway in an acute care setting. BACKGROUND Dementia care in acute settings is often constrained by contextual factors. We developed an evidence-based care pathway with intervention bundles, and implemented it on two trauma units, with the aim to empower staff and improve quality care. DESIGN Process evaluation using quantitative and qualitative methods. METHODS Pre-implementation, unit staff completed a survey (n = 72) assessing family and dementia care skills and level of evidence-based dementia care. Post-implementation, champions (n = 7) completed the same survey, with additional questions on acceptability, appropriateness and feasibility, and participated in a focus group interview. Data were analysed using descriptive statistics and content analysis guided by the Consolidated Framework for Implementation Research (CFIR). REPORTING GUIDELINE Standards for Reporting Qualitative Research Checklist. RESULTS Pre-implementation, staff's perceived skills in family and dementia care were moderate overall, with high skills in 'building relationships' and 'sustaining personhood'. Evidence-based interventions were delivered seldom to frequent, with 'individualized care' scoring lowest and 'assessing cognition' scoring highest. Implementation of the care pathway/intervention bundles was overshadowed by the pandemic, and failed due to major organisational- and process-related barriers. Acceptability scored highest and feasibility lowest, with concerns relating to complexity and compatibility of pathways/bundles when introduced into clinical routines. CONCLUSIONS Our study implies that organisational and process factors are the most influential determinants to the implementation of dementia care in acute settings. Future implementation efforts should draw on the evolving evidence within implementation science and dementia care research to ensure effective integration and improvement process. RELEVANCE TO CLINICAL PRACTICE Our study provides important learning around improving care for persons with dementia and their families in hospitals. PATIENT OR PUBLIC CONTRIBUTION A family caregiver was involved in the development of the education and training programme.
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Affiliation(s)
- Heidi Petry
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Jutta Ernst
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Rahel Naef
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
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Akaida S, Tabira T, Nakai Y, Maruta M, Taniguchi Y, Tomioka K, Sato N, Wada A, Makizako H. Are satisfaction and performance of meaningful activities associated with frailty in older adults? Arch Gerontol Geriatr 2023; 105:104845. [PMID: 36347156 DOI: 10.1016/j.archger.2022.104845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/09/2022] [Accepted: 10/19/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Shoma Akaida
- Graduate School of Health Sciences, Kagoshima University, Japan; Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Japan
| | - Takayuki Tabira
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Japan
| | - Yuki Nakai
- Department of Mechanical Systems Engineering, Daiichi Institute of Technology, Japan
| | - Michio Maruta
- Department of Occupational Therapy, Nagasaki University Graduate School of Biomedical Sciences, Health Sciences, Japan
| | - Yoshiaki Taniguchi
- Graduate School of Health Sciences, Kagoshima University, Japan; Department of Physical Therapy, Kagoshima Medical Professional College, Japan
| | - Kazutoshi Tomioka
- Department of Rehabilitation, Tarumizu Municipal Medical Center Tarumizu Chuo Hospital, Japan
| | - Nana Sato
- Division of Rehabilitation, Kurume University Hospital, Japan
| | - Ayumi Wada
- National Hospital Organization Osaka Toneyama Medical Center, Department of Rehabilitation, Japan
| | - Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Japan.
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An Outpatient-Based Training Program Improves Family Caregivers' Preparedness in Caring for Persons With Mild Cognitive Impairment: A Randomized Controlled Trial. THE JOURNAL OF NURSING RESEARCH : JNR 2023; 31:e252. [PMID: 36692834 DOI: 10.1097/jnr.0000000000000541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Little is known regarding the effects of training programs on family caregivers of older persons with mild cognitive impairment because of the significant differences in outcome variables measured in the various studies in the literature. PURPOSE This study was designed to examine the effects of an outpatient-based caregiver training program on the preparedness, health-related quality of life, and depressive symptoms of participants responsible for caring for older persons with mild cognitive impairment. METHODS A randomized clinical trial was implemented. Of the 54 family caregiver participants who provided complete and valid data, 28 and 26 were assigned to the experimental and control groups, respectively. The experimental group participated in a researcher-developed training program that provided information on mild cognitive impairment, strategies for maintaining and promoting cognitive function in persons with mild cognitive impairment, managing their own and their care recipients' healthcare, and managing their own emotional support and stress. Outcomes (caregiver preparedness, health-related quality of life, and depressive symptoms) were assessed before the start of the training program (baseline) and at 1, 3, and 6 months after completion of the program. RESULTS After controlling for baseline cognitive function of the care recipients and of caregiver preparedness, the experimental group was shown to be significantly less prepared than the control group at baseline (β = -1.41, p = .031) and better prepared than the control group at all three posttests (group differences: 1.3, 1.53, and 4.24, respectively), with the difference at the third posttest (6 months) reaching statistical significance (p = .008). No impact of the intervention on caregiver depressive symptoms or health-related quality of life was found at posttest. CONCLUSIONS The training intervention in this study was found to increase the perceived preparedness of the family caregiver participants to handle various aspects of providing care to persons with mild cognitive impairment. However, no changes were found in depressive symptoms or health-related quality of life.
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Phetsitong R, Vapattanawong P, Mayston R, Prince M, Chua KC. In Caring for Older People in Low- and Middle-Income Countries, Do Older Caregivers Have a High Level of Care Burden and Psychological Morbidity Compared to Younger Caregivers? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416405. [PMID: 36554286 PMCID: PMC9778435 DOI: 10.3390/ijerph192416405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/25/2022] [Accepted: 11/30/2022] [Indexed: 06/02/2023]
Abstract
Caregivers have become older as longevity increases. Caregiving for older people can cause burdens and psychological morbidity, which are the chronic stresses perceived by informal caregivers. This study aimed to compare the levels of care burden and psychological morbidity between older and younger caregivers in low- and middle-income countries. A cross-sectional survey was conducted in Cuba, the Dominican Republic, Peru, Venezuela, Mexico, Puerto Rico, and China. Data were collected by the 10/66 Dementia Research Group. The Zarit Burden Inventory was used to measure the levels of burden on caregivers. Psychological morbidity was assessed through the Self-Reporting Questionnaire. Data from 1348 households in which informal caregivers provided home care for one older person were included in the analysis. Multivariable logistic regression was used to investigate the effects of caregiver age upon care burden and psychological morbidity. A fixed-effect meta-analysis model was used to obtain a pooled estimate of the overall odds ratios of each country. The unadjusted and the adjusted model for potential covariates revealed no significant difference in care burden and psychological morbidity between older caregivers and younger caregivers. The adjusted pooled estimates, however, indicated a lower psychological morbidity among older caregivers (OR = 0.61, 95% CI: 0.41-0.93, I2 = 0.0%). The demographic implications of caregiver age may suggest different policy responses across low- and middle-income countries.
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Affiliation(s)
- Ruttana Phetsitong
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom 73170, Thailand
| | - Patama Vapattanawong
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom 73170, Thailand
| | - Rosie Mayston
- Department of Global Health and Social Medicine, Social Science and Public Policy, King’s College London, London WC2R 2LS, UK
| | - Martin Prince
- King’s Global Health Institute, King’s College London, London WC2R 2LS, UK
| | - Kia-Chong Chua
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
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Cham CQ, Ibrahim N, Siau CS, Kalaman CR, Ho MC, Yahya AN, Visvalingam U, Roslan S, Abd Rahman FN, Lee KW. Caregiver Burden among Caregivers of Patients with Mental Illness: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10122423. [PMID: 36553947 PMCID: PMC9777672 DOI: 10.3390/healthcare10122423] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
Due to the increasing importance of caregivers in the treatment outcomes of patients with mental illness, this study aimed to systematically review studies investigating the former's caregiver burden and determine its prevalence. An open search, without filters, was conducted. Articles were selected from Medline, Scopus, and PubMed from inception to 30 April 2022 using the PRISMA protocol. Subgroup analyses examined the between-group differences by study setting, measurements used, and disorder type. A total of 5034 caregivers from 23 countries were included in this review. Thirty-nine studies were included in the systematic review, and, among them, twenty-six were deemed eligible for meta-analysis. The overall pooled prevalence of caregiver burden among caregivers of individuals with mental illness was 31.67% (95% CI = 26.22-37.12). Pooled prevalence was the highest among care recipients receiving treatment in a hospital setting (36.06%; 95% CI = 22.50-49.63), followed by the community and clinic settings. Caregiver prevalence values were higher for burden measured using the Zarit Burden Interview (38.05%; 95% CI = 27.68-48.43). compared with other instruments, and for carers of care recipients with psychosis (35.88%; 95% CI = 27.03-44.72) compared with those without. Thus, targeted interventions should focus on caregivers of patients in hospital settings and with psychotic symptoms.
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Affiliation(s)
- Choy Qing Cham
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (C.Q.C.); (C.R.K.)
| | - Norhayati Ibrahim
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (C.Q.C.); (C.R.K.)
- Institute of Islam Hadhari, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
- Correspondence:
| | - Ching Sin Siau
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
| | - Clarisse Roswini Kalaman
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (C.Q.C.); (C.R.K.)
| | - Meng Chuan Ho
- Centre for Pre-U Studies, UCSI University (Springhill Campus), Port Dickson 71010, Malaysia;
| | - Amira Najiha Yahya
- Department of Educational Psychology & Counselling, Faculty of Education, Universiti Malaya, Kuala Lumpur 50603, Malaysia;
| | - Uma Visvalingam
- Department of Psychiatry, Hospital Putrajaya, Putrajaya 62250, Malaysia;
| | - Samsilah Roslan
- Department of Foundation of Education, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang 43400, Malaysia;
| | - Fairuz Nazri Abd Rahman
- Psychiatry Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Kai Wei Lee
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor 43400, Malaysia;
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Jesus AG, de Lima MP, Vilar M, Pachana NA. Feasibility, Acceptability, and Preliminary Efficacy of A Cognitive-Emotional Intervention Program in Homebound Older Adults: A Pilot Randomized Controlled Trial. Clin Gerontol 2022; 46:359-375. [PMID: 35916398 DOI: 10.1080/07317115.2022.2105670] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To conduct a pilot randomized controlled trial to assess the feasibility, acceptability, and preliminary efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI) among homebound older adults with mild cognitive impairment and depressive or anxious symptomatology. METHODS Fifty-one participants were randomly assigned to the intervention group or to the wait-list control group and completed baseline and post-intervention assessments. Feasibility and acceptability were the primary outcomes. Secondary outcomes included changes in cognitive function, depressive and anxiety symptoms, subjective memory complaints, functional status, and quality of life. Intervention effects were assessed both at a group level (two-way mixed ANOVA) and at an individual level (Reliable Change Index). RESULTS The HEPPI was a feasible and acceptable non-pharmacological intervention. Compared to the wait-list control group, the intervention group showed significant improvement in cognitive, emotional, and functional domains at post-intervention. Differences between groups in the distributions by clinical change categories were observed. CONCLUSIONS Results provide evidence of the HEPPI's feasibility, acceptability, and preliminary efficacy in increasing the cognitive and functional performance of homebound older adults and reducing their psychological symptomatology. CLINICAL IMPLICATIONS Home-delivered cognitive-emotional interventions may be a promising and acceptable mental health approach for homebound older adults, improving their cognitive and emotional functioning.
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Affiliation(s)
- Andreia G Jesus
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | | | - Manuela Vilar
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Australia
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Koh YS, Subramaniam M, Matchar DB, Hong SI, Koh GCH. The associations between caregivers’ psychosocial characteristics and caregivers’ depressive symptoms in stroke settings: a cohort study. BMC Psychol 2022; 10:121. [PMID: 35534900 PMCID: PMC9082830 DOI: 10.1186/s40359-022-00828-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 05/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background Studies have found that caregivers can influence stroke survivors’ outcomes, such as mortality. It is thus pertinent to identify significant factors associated with caregivers’ outcomes. The study objective was to examine the associations between caregivers’ psychosocial characteristics and caregivers’ depressive symptoms. Methods The analysis obtained three-month and one-year post-stroke data from the Singapore Stroke Study, which was collected from hospital settings. Caregivers’ depressive symptoms were assessed via the Center for Epidemiologic Studies Depression instrument. Psychosocial characteristics of caregivers included subjective burden (Zarit Burden Interview), quality of care-relationship (a modified 3-item scale from the University of Southern California Longitudinal Study of Three-Generation Families) and expressive social support (an 8-item scale from Pearlin et al.). Mixed effect Tobit regressions were used to examine the associations between these study variables. Results A total of 214 caregivers of stroke patients hospitalized were included in the final analysis. Most caregivers were Chinese women with secondary school education, unemployed and married to the patients. Caregivers' subjective burden was positively associated with their depressive symptoms (Partial regression coefficient: 0.18, 95% CI 0.11–0.24). Quality of care-relationship (Partial regression coefficient: − 0.35, 95% CI − 0.63 to − 0.06) and expressive social support (partial regression coefficient: − 0.28, 95% CI − 0.37 to − 0.19) were negatively associated with caregivers’ depressive symptoms. Caregivers’ depressive symptoms were higher at three-month post-stroke than one-year post-stroke (Partial regression coefficient: − 1.00, 95% CI − 1.80 to − 0.20). Conclusion The study identified subjective burden, quality of care-relationship and expressive social support as significantly associated with caregivers’ depressive symptoms. Caregivers’ communication skills may also play a role in reducing caregivers’ depressive symptoms. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00828-2.
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Thurin K, Daffner K, Gale S, Donovan NJ, Urizar JC. Non-Pharmacological Treatments of Neuropsychiatric Symptoms in Mild Cognitive Impairment (MCI). Semin Neurol 2022; 42:192-203. [DOI: 10.1055/s-0042-1742486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractMild cognitive impairment (MCI) is a syndrome defined by objective cognitive deficits that do not impact functional independence. Individuals with MCI develop dementia at an annual rate of 10 to 15%. Neuropsychiatric symptoms (NPS) are common non-cognitive features of neurocognitive disorders and have a major impact on the wellbeing and quality of life of affected individuals and their families. Non-pharmacological interventions for NPS are considered the first-line treatment because of the limited efficacy and side-effect potential of current pharmacological agents. This article summarizes the literature on non-pharmacological treatments for NPS in MCI. The limited number of studies specific to individuals with MCI and its various etiologies, as well as the overall heterogeneity of research design and methodologies, make the evidence base inconclusive. Nevertheless, some studies support psychosocial interventions aimed at individuals with MCI and their caregivers.
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Affiliation(s)
- Kristina Thurin
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Kirk Daffner
- Division of Cognitive and Behavioral Neurology, Department of Neurology, Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Seth Gale
- Division of Cognitive and Behavioral Neurology, Department of Neurology, Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nancy J. Donovan
- Division of Geriatric Psychiatry, Departments of Psychiatry and Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Juan Carlos Urizar
- Division of Geriatric Psychiatry, Departments of Psychiatry and Neurology, Brigham andWomen's Hospital, Harvard Medical School, Boston, Massachusetts
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Examining the Influence of Social Interactions and Community Resources on Caregivers' Burden in Stroke Settings: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312310. [PMID: 34886031 PMCID: PMC8656532 DOI: 10.3390/ijerph182312310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/19/2021] [Accepted: 11/21/2021] [Indexed: 01/19/2023]
Abstract
Since the introduction of the integrated care model, understanding how social interactions and community resources can alleviate caregivers’ burden is vital to minimizing negative patients’ outcomes. This study (n = 214) examined the associations between these factors and caregivers’ burden in stroke settings. It used 3-month and 1-year post-stroke data collected from five tertiary hospitals. Subjective and objective caregivers’ burdens were measured using Zarit burden interview and Oberst caregiving burden scale respectively. The independent variables examined were quality of care relationship, care management strategies for managing patients’ behaviour, family caregiving conflict, formal service usage and assistance to the caregiver. Significant associations were determined using mixed effect modified Poisson regressions. For both types of burden, the scores were slightly higher at 3 months as compared to 1 year. Poorer care-relationship (relative risk: 0.81, 95% confidence interval (CI): 0.70–0.94) and adopting positive care management strategies (relative risk: 1.05, 95% CI: 1.02–1.07) were independently associated with a high subjective burden. Providing assistance to caregivers (relative risk: 2.45, 95% CI: 1.72–3.29) and adopting positive care management strategies (relative risk: 1.03, 95% CI: 1.02–1.04) were independently associated with a high objective burden. Adopting positive care management strategies at 3 months had a significant indirect effect (standardised β: 0.11, 95% CI: 0.01 to 0.20) on high objective burden at one year. Healthcare providers should be aware that excessive care management strategies and assistance from family members may add to caregivers’ burden.
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Spiers GF, Liddle J, Kunonga TP, Whitehead IO, Beyer F, Stow D, Welsh C, Ramsay SE, Craig D, Hanratty B. What are the consequences of caring for older people and what interventions are effective for supporting unpaid carers? A rapid review of systematic reviews. BMJ Open 2021; 11:e046187. [PMID: 34588234 PMCID: PMC8483048 DOI: 10.1136/bmjopen-2020-046187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 08/26/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To identify and map evidence about the consequences of unpaid caring for all carers of older people, and effective interventions to support this carer population. DESIGN A rapid review of systematic reviews, focused on the consequences for carers of unpaid caring for older people, and interventions to support this heterogeneous group of carers. Reviews of carers of all ages were eligible, with any outcome measures relating to carers' health, and social and financial well-being. Searches were conducted in MEDLINE, PsycInfo and Epistemonikos (January 2000 to January 2020). Records were screened, and included systematic reviews were quality appraised. Summary data were extracted and a narrative synthesis produced. RESULTS Twelve systematic reviews reporting evidence about the consequences of caring for carers (n=6) and assessing the effectiveness of carer interventions (n=6) were included. The review evidence typically focused on mental health outcomes, with little information identified about carers' physical, social and financial well-being. Clear estimates of the prevalence and severity of carer outcomes, and how these differ between carers and non-carers, were absent. A range of interventions were identified, but there was no strong evidence of effectiveness. In some studies, the choice of outcome measure may underestimate the full impact of an intervention. CONCLUSIONS Current evidence fails to fully quantify the impacts that caring for older people has on carers' health and well-being. Information on social patterning of the consequences of caring is absent. Systematic measurement of a broad range of outcomes, with comparison to the general population, is needed to better understand the true consequences of caring. Classification of unpaid caring as a social determinant of health could be an effective lever to bring greater focus and support to this population. Further work is needed to develop and identify suitable interventions in order to support evidence-based policymaking and practice.
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Affiliation(s)
- Gemma F Spiers
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jennifer Liddle
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- NIHR Applied Research Collaboration North East & North Cumbria, Newcastle upon Tyne, UK
| | | | | | - Fiona Beyer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Daniel Stow
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Claire Welsh
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Sheena E Ramsay
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Dawn Craig
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- NIHR Applied Research Collaboration North East & North Cumbria, Newcastle upon Tyne, UK
| | - Barbara Hanratty
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- NIHR Applied Research Collaboration North East & North Cumbria, Newcastle upon Tyne, UK
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15
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Juengst S, Supnet C, Kew CLN, Silva V, Vega M, Han G, Kelley B, Smith ML, Maestre G. Bilingual problem-solving training for caregivers of adults with dementia: A randomized, factorial-design protocol for the CaDeS trial. Contemp Clin Trials 2021; 108:106506. [PMID: 34273551 PMCID: PMC8453060 DOI: 10.1016/j.cct.2021.106506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/06/2021] [Accepted: 07/10/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Caregivers of individuals with Alzheimer's disease and related dementias (ADRD) often experience debilitating caregiver burden and emotional distress. To address these negative emotional consequences of caregiving, we will test and refine a strategy training intervention - Problem-Solving Training (PST) - that promotes self-efficacy and reduces caregiver burden and depressive symptoms. Previous research supports efficacy of PST; however, we do not know exactly how many PST sessions are needed or if post-training "boosters" are required to maintain PST benefits. Additionally, we translated and culturally-adapted PST into "Descubriendo Soluciones Juntos" (DSJ), our novel intervention for Spanish-speaking caregivers. METHOD In this 2 × 2 factorial design randomized controlled trial, we will test remotely-delivered PST/DSJ sessions for both English- and Spanish-speaking caregivers of persons with ADRD to determine the optimal number of PST/DSJ sessions and ongoing "booster" sessions needed to best help caregivers navigate their current and future needs. AIMS 1) Compare the efficacy of three vs. six PST/DSJ sessions each with and without booster sessions for decreasing caregiver burden and depression and enhancing caregiver problem-solving; 2) Identify key factors associated with efficacy of PST/DSJ, including age, gender, primary language, relationship to care recipient, and uptake of the PST/DSJ strategy. RESULTS These results will establish guidelines needed for an evidence-based, culturally-adapted, and implementable problem-solving intervention to reduce caregiver stress and burden and improve caregiver health and well-being. CONCLUSION This work promotes inclusion of diverse and underserved populations and advances therapeutic behavioral interventions that improve the lives of caregivers of individuals with chronic conditions.
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Affiliation(s)
- ShannonB Juengst
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States of America; Department of Applied Clinical Research, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States of America.
| | - Charlene Supnet
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States of America
| | - Chung Lin Novelle Kew
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States of America; Department of Applied Clinical Research, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States of America
| | - Valeria Silva
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States of America
| | - Marlene Vega
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States of America; Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States of America
| | - Gang Han
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, 212 Adriance Lab Road, College Station, TX 77843, United States of America; Center for Population Health and Aging, Texas A&M University, 212 Adriance Lab Road, College Station, TX 77843, United States of America
| | - Brendan Kelley
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States of America
| | - Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, 212 Adriance Lab Road, College Station, TX 77843, United States of America; Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, 212 Adriance Lab Road, College Station, TX 77843, United States of America
| | - Gladys Maestre
- School of Medicine, University of Texas Rio Grande Valley, One West University Boulevard, Brownsville, TX 78520, United States of America
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Chen Z, Wang L, Chen K, Mi Q, Zu X, Xu Q, Na W, He W, Li X, Xu C, Wang F, Shen C, Shao L, Tang C, Shen X. The effects of a multi-disciplinary team on sleep quality assessment in mild-to-moderate Alzheimer's disease patients with sleep disorders. Scott Med J 2021; 66:134-141. [PMID: 34225517 DOI: 10.1177/00369330211027450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Sleep disturbances are a severe problem among patients with Alzheimer's disease (AD). By evaluating sleep quality in mild-to-moderate AD patients, this study aimed to assess the effects of multi-disciplinary team (MDT) in reducing the incidence of adverse reactions of AD patients. The reduction in the incidence of adverse reactions to predict multi-disciplinary team (MDT) treatment effects. METHODS AND RESULTS This study included 60 mild-to-moderate AD patients with sleep problems when hospitalized in Huzhou Third Municipal Hospital. The patients were randomly distributed into two groups, routine and MDT treatments. The cognitive functions, sleep conditions, and psycho-behavioral symptoms were compared between both the groups. Cognitive function declined significantly between pretherapy and follow-up in the routine treatment group (MMSE: t = -7.961, P < 0.001; MoCA: t = -4.672, P < 0.001). There was a significant decline in drowsiness in the MDT group compared to that in the routine treatment group (χ2 = 4.320, P = 0.038). Sleep quality improved significantly during the follow-up in the MDT treatment group (t = 6.098, P < 0.001). The results of the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) among family caregivers (FCGs) demonstrated that MDT treatment could alleviate caregivers' depression (t = -2.867, P = 0.042), and routine treatment can worsen their anxiety (t = 3.258, P = 0.003). CONCLUSION The MDT treatment method as an effective and meaningful therapy can help mitigate the suffering of patients with AD and FCGs.
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Affiliation(s)
- Zheli Chen
- Associate Chief Physician, Department of Geriatric Psychiatry in Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, China
| | - Lan Wang
- Doctor-In-Charge, Department of Geriatric Psychiatry in Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, China
| | - Ke Chen
- Chief Physician, Department of Geriatric Psychiatry in Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, China
| | - Qu Mi
- Associate Chief Physician, Department of Geriatric Psychiatry in Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, China
| | - Xin Zu
- Associate Chief Physician, Department of Geriatric Psychiatry in Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, China
| | - Qiuxia Xu
- Doctor-In-Charge, Department of Geriatric Psychiatry in Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, China
| | - Wanqiu Na
- Associate Chief Physician, Department of Geriatric Psychiatry in Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, China
| | - Weiliang He
- Associate Chief Physician, Department of Geriatric Psychiatry in Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, China
| | - Xuefeng Li
- Pharmacist-In-Charge, Department of Clinical Pharmacy in Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, China
| | - Chunyun Xu
- Nurse-In-Charge, Department of Geriatric Psychiatry in Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, China
| | - Fei Wang
- Nurse-In-Charge, Department of Geriatric Psychiatry in Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, China
| | - Chunli Shen
- Nurse-In-Charge, Department of Geriatric Psychiatry in Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, China
| | - Lei Shao
- Associate Nurse-In-Charge, Department of Geriatric Psychiatry in Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, China
| | - Chenyun Tang
- Rehabilitative Physician, Department of Rehabilitation in Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, China
| | - Xinhua Shen
- Chief Physician, Department of Psychosomatic Disorders in Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, China
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17
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Effects of a home-based exercise program on mental health for caregivers of relatives with dementia: a randomized controlled trial. Int Psychogeriatr 2021; 33:359-372. [PMID: 32893767 DOI: 10.1017/s104161022000157x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study was aimed to evaluate the effectiveness of a home-based physical exercise program on participants' mental health: psychological symptoms, depression, and burden of female informal caregivers. DESIGN AND PARTICIPANTS In a randomized controlled trial, a sample of 48 female informal primary caregivers completed the entire study, 25 were randomly allocated to the intervention group (IG), and 23 participants to the control group (CG). INTERVENTION Participants in the IG performed two 60-minute-long physical exercise sessions per week (36 weeks) that were supervised by a personal trainer at caregivers' home during 9 months. The CG continued their habitual leisure-time activities. MEASUREMENTS Subjective burden was assessed by the Zarit Burden Interview. The risk of depression was measured by the Geriatric Depression Scale Short Form 15-item version, and psychological symptoms were evaluated by the Symptom Check List-90-Revised (SCL-90-R). All participants were evaluated at baseline and at the end of the intervention. RESULTS A promising positive impact of the intervention on caregivers' subjective burden and risk of depression was found in the IG. In addition, no significant between-group differences were found in any of nine subscales scores of the SCL-90-R. Finally, care recipients' level of functional independence and area of residence were found to be predictors of the promising positive impact on caregivers' subjective burden and risk of depression. CONCLUSIONS The present home-based physical exercise intervention that was individually implemented has shown promising results to reduce subjective burden and risk of depression in female caregivers of relatives with dementia. However, future research efforts should elucidate both the particular dose of physical exercise and the particular duration of the intervention that are required to obtain the expected significant positive impact. Finally, future inclusion of psychological approaches, besides physical exercise, might help reduce female caregivers' psychological symptoms.
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18
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Feligreras-Alcalá D, Cazalilla-López MDP, del-Pino-Casado R, Frías-Osuna A. Validity and Reliability of the Caregiver Strain Index Scale in Women during the Puerperium in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073602. [PMID: 33808482 PMCID: PMC8036977 DOI: 10.3390/ijerph18073602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/26/2021] [Accepted: 03/27/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND The objective of this study is to determine the validity and reliability of the Caregiver Strain Index (CSI) for women during the postpartum period. Methods: This is a validation study of a measurement instrument. This study includes 212 women over the age of 19 who gave birth from March to September 2019 in Maternal and Child Hospital of Jaén (Spain). The items of the CSI were adapted for newborn care. Content validity was measured by five experts, calculating the index of agreement (Aiken's V). Criterion validity was assessed by correlations with scores of other tools that measure constructs related to burden (Edinburgh Postpartum Depression Scale, State-Trait Anxiety Questionnaire, SOC-13 and Duke-UNC-11). Construct validity was determined by the known-groups method. Internal consistency was measured using Cronbach's Alpha, and stability was analysed using the intraclass correlation coefficient (ICC). RESULTS Regarding content validity, an Aiken's V of 1.00 (p = 0.032) was obtained. Regarding criterion validity, the correlation analyses showed statistically significant coefficients between the scores of the questionnaire and those of the sense of coherence (r = -0.447, p < 0.001), depressive symptoms (r = 0.429, p < 0.001), social support (rho = -0.379, p < 0.001) and anxiety symptoms (r = 0.532, p < 0.001). The known-groups method showed statistically significant differences in the mean of subjective burden between the groups (depressive symptoms, anxiety symptoms, sense of coherence and social support). The total scale obtained a Cronbach's alpha value of 0.710. The ICC was 0.979. CONCLUSIONS The adapted CSI is a valid and reliable screening tool for the subjective burden in women during the puerperium. The adapted CSI can play an important role as a guide to detect the subjective burden in women during the puerperium.
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19
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Derby CA, Katz MJ, Rozner S, Lipton RB, Hall CB. A Birth Cohort Analysis of Amnestic Mild Cognitive Impairment Incidence in the Einstein Aging Study (EAS) Cohort. J Alzheimers Dis 2020; 70:S271-S281. [PMID: 31256119 PMCID: PMC6700647 DOI: 10.3233/jad-181141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND The transition from normal cognition to Alzheimer's disease is considered a continuum, with amnestic mild cognitive impairment (aMCI) an intermediate clinical cognitive state. Although prior work suggests that dementia incidence rates may be declining, there is little information regarding temporal trends in aMCI incidence. OBJECTIVE To determine whether age specific rates of aMCI have changed over sequential birth cohorts among individuals included in the population-based Einstein Aging Study (EAS) cohort. A secondary objective was to examine trends in aMCI rates among Blacks and Whites and by sex. METHODS Age specific incidence of aMCI was examined by birth year among 1,233 individuals age 70 years and above enrolled in the population-based EAS cohort between November 1, 1993 and February 22, 2016 and who had at least one annual follow-up assessment (5,321 person years of follow-up). Poisson regression was used to determine whether there has been a change in age specific aMCI rates over sequential years of birth. RESULTS No significant change in aMCI rates was identified in the overall cohort, among Blacks or Whites, or among males or females born between 1899 and 1946. CONCLUSIONS Despite a trend for decreased dementia incidence in the EAS cohort, rates of incident aMCI have not changed. These apparently conflicting results may indicate a delay or decrease in the rates of transition from aMCI to dementia within the cohort. However, further studies are needed to confirm whether rates of aMCI have changed in other populations, and how aMCI rates are related to secular trends in dementia risk factors.
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Affiliation(s)
- Carol A Derby
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mindy J Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sara Rozner
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Richard B Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Charles B Hall
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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20
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Montero-Cuadrado F, Galán-Martín MÁ, Sánchez-Sánchez J, Lluch E, Mayo-Iscar A, Cuesta-Vargas Á. Effectiveness of a Physical Therapeutic Exercise Programme for Caregivers of Dependent Patients: A Pragmatic Randomised Controlled Trial from Spanish Primary Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207359. [PMID: 33050179 PMCID: PMC7601365 DOI: 10.3390/ijerph17207359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/28/2020] [Accepted: 10/01/2020] [Indexed: 01/22/2023]
Abstract
Female family caregivers (FFCs) constitute one of the basic supports of socio-health care for dependence in developed countries. The care provided by FFCs may impact their physical and mental health, negatively affecting their quality of life. In order to alleviate the consequences of providing care on FFCs, the Spanish Public Health System has developed the family caregiver care programme (FCCP) to be applied in primary care (PC) centres. The effectiveness of this programme is limited. To date, the addition of a physical therapeutic exercise (PTE) programme to FCCP has not been evaluated. A randomised multicentre clinical trial was carried out in two PC centres of the Spanish Public Health System. In total, 68 FFCs were recruited. The experimental group (EG) performed the usual FCCP (4 sessions, 6 h) added to a PTE programme (36 sessions in 12 weeks) whereas the control group performed the usual FCCP performed in PC. The experimental treatment improved quality of life (d = 1.17 in physical component summary), subjective burden (d = 2.38), anxiety (d = 1.52), depression (d = 1.37) and health-related physical condition (d = 2.44 in endurance). Differences between the groups (p < 0.05) were clinically relevant in favour of the EG. The experimental treatment generates high levels of satisfaction.
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Affiliation(s)
- Federico Montero-Cuadrado
- Unit for Active Coping Strategies for Pain in Primary Care, East-Valladolid Primary Care Management, Castilla and Leon Public Health System (Sacyl), 47011 Valladolid, Spain; (F.M.-C.); (M.Á.G.-M.)
| | - Miguel Ángel Galán-Martín
- Unit for Active Coping Strategies for Pain in Primary Care, East-Valladolid Primary Care Management, Castilla and Leon Public Health System (Sacyl), 47011 Valladolid, Spain; (F.M.-C.); (M.Á.G.-M.)
| | - Javier Sánchez-Sánchez
- Department of Physical Activity and Sports Sciences, University Pontificia of Salamanca, 37002 Salamanca, Spain;
- Research Group “Planning and assessment of training and athletic performance”, 37002 Salamanca, Spain
| | - Enrique Lluch
- Department of Physical Therapy, University of Valencia, 46010 Valencia, Spain;
- Pain in Motion “International Research Group”, 1090 Brussels, Belgium
- Department of Human Physiology and Rehabilitation Sciences, Faculty of Physiotherapy, Vrije University Brussels, B-1050 Brussels, Belgium
| | - Agustín Mayo-Iscar
- Department of Statistics and Operational Research and IMUVA, University of Valladolid, 47005 Valladolid, Spain;
| | - Ántonio Cuesta-Vargas
- Department of Physiotherapy, Faculty of Heath Sciences, University of Malaga, 19071 Málaga, Spain
- Institute of Biomedical Research in Malaga (IBIMA), 29010 Málaga, Spain
- School of Clinical Science, Faculty of Health Science, Queensland University Technology, Brisbane, QLD 4000, Australia
- Correspondence:
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Affiliation(s)
- Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
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Cost-Effectiveness and Effects of a Home-Based Exercise Intervention for Female Caregivers of Relatives with Dementia: Study Protocol for a Randomized Controlled Trial. Healthcare (Basel) 2020; 8:healthcare8010054. [PMID: 32155761 PMCID: PMC7151160 DOI: 10.3390/healthcare8010054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/28/2020] [Accepted: 03/03/2020] [Indexed: 12/14/2022] Open
Abstract
Previous research has proposed a range of support interventions to mitigate the adverse impact of caregiving on the daily life of caregivers of relatives with dementia. However, the effectiveness of these interventions shows a high variability. Informal caregivers usually lack the time and/or live too far from conventional facilities to do physical exercise, especially those who live in rural areas. Thus, home-based interventions may be more efficacious due to their greater convenience for this population. The present work proposes and describes a study protocol for a randomized control trial that will analyze the efficacy and cost-effectiveness of a home-based, structured individual physical exercise intervention to improve the health-related quality of life and the mental health of female informal caregivers of relatives with dementia. The nine-month-long intervention will comprise participation in two supervised physical exercise sessions per week at the caregiver’s home. The proposed study outcomes will be: (1) feasibility of and adherence to the home-based provision of the intervention; (2) improvement in physical fitness and quality of life; and (3) reduction in subjective burden, psychological symptomatology and depression. Analyses will also be performed to determine the cost-effectiveness after the intervention. In conclusion, this intervention might thus represent a tailored and feasible strategy to help caregivers cope with the physical and psychological stress resulting from caregiving-related responsibilities, and it could represent a novel cost-effective support home-based intervention for caregivers.
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Mavounza C, Ouellet MC, Hudon C. Caregivers' emotional distress due to neuropsychiatric symptoms of persons with amnestic mild cognitive impairment or Alzheimer's disease. Aging Ment Health 2020; 24:423-430. [PMID: 30588847 DOI: 10.1080/13607863.2018.1544208] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Compared to the literature on Alzheimer's disease (AD), less is known about the emotional distress of caregivers of persons with amnestic Mild Cognitive Impairment (aMCI). This study describes and compares emotional distress due to neuropsychiatric symptoms (NPS) among children and spousal caregivers of aMCI or mild AD care recipients. It also examined the association between the frequency and severity of NPS and caregivers' emotional distress. In total, 108 spouses or children of persons with aMCI or mild AD were administered the Neuropsychiatric Inventory, measuring the frequency/severity of NPS in the patient as well as the associated caregiver's emotional distress. Emotional distress due to each NPS was compared between children and spouses and the relationship between NPS and emotional distress was assessed. There was no significant difference in emotional distress between aMCI and mild AD spousal caregivers for all symptoms, but for children caregivers, emotional distress was significantly higher in the mild AD group than in the aMCI group. Regardless of the caregiver's relationship to the patient or the condition (aMCI vs mild AD) of the latter, there was a positive relationship between the frequency/severity of NPS and caregiver emotional distress. Caregivers of persons with aMCI experienced emotional distress due to the presence of NPS in their significant others at a level that is generally similar to that experienced by caregivers of persons with mild AD. This study highlights the need for interventions to reduce emotional burden by helping caregivers manage NPS in care recipients.
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Affiliation(s)
- Céline Mavounza
- CERVO Brain Research Centre, Québec, Canada.,École de psychologie, Université Laval, Québec, Canada
| | - Marie-Christine Ouellet
- École de psychologie, Université Laval, Québec, Canada.,Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Québec, Canada
| | - Carol Hudon
- CERVO Brain Research Centre, Québec, Canada.,École de psychologie, Université Laval, Québec, Canada
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Yu DSF, Li PWC, Zhang F, Cheng ST, Ng TK, Judge KS. The effects of a dyadic strength-based empowerment program on the health outcomes of people with mild cognitive impairment and their family caregivers: a randomized controlled trial. Clin Interv Aging 2019; 14:1705-1717. [PMID: 31686796 PMCID: PMC6783396 DOI: 10.2147/cia.s213006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 07/10/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose As an intermediate prodromal stage of dementia, mild cognitive impairment (MCI) causes functional, emotional, and social challenges for both of the person with MCI (PwMCI) and their family caregiver. However, major attention has only been placed on the PwMCI’s for cognitive training. This study evaluated a more comprehensive intervention, which integrated both strength-based and empowerment approaches, to address their complex needs in a dyadic fashion. Patients and methods This randomized controlled trial allocated 103 MCI patient-caregiver dyads to receive a 14-week dyadic strength-based empowerment program (D-StEP-MCI, n=52) or usual care (n=51). The D-StEP-MCI program consisted of group-based session to the PwMCI, home-based dyadic sessions, and telephone follow-up, with the activities supported the care dyads to navigate their own strengths and resources for integration, together with the trained skills, to optimize role and social engagement in everyday life. Dyadic health outcomes in terms of subjective and objective cognitive function, and neuro-psychiatric symptoms of PwMCI, stress in symptom management of their family caregivers, and depression of the dyads were evaluated at baseline, after the D-StEP-MCI and at 3 months thereafter. Results By using general estimating equation, the D-StEP-MCI significantly improved the cognitive function, subjective memory, and mood status of the PwMCI, and the positive changes were maintained at the 3-month endpoints. It also has significantly positive effects on caregivers’ stress in symptom management and level of depression. Conclusion Our findings showed the health benefit of combining strength-based and empowerment approach in supporting the disease adaptation of PwMCI and caregiver in a dyadic fashion. This study also supports the use of a social interaction approach to optimize the everyday engagement of the PwMCI.
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Affiliation(s)
- Doris Sau-Fung Yu
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Polly Wai-Chi Li
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Fan Zhang
- Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Sheung-Tak Cheng
- Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Tsz Kwan Ng
- Fong Shu Chuen District Elderly Community Centre, Tung Wah Group Hospital, Sheung Wan, Hong Kong
| | - Katherine S Judge
- Department of Psychology, College of Sciences and Health Professions, Cleveland State University, Cleveland, OH, USA
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del-Pino-Casado R, Rodríguez Cardosa M, López-Martínez C, Orgeta V. The association between subjective caregiver burden and depressive symptoms in carers of older relatives: A systematic review and meta-analysis. PLoS One 2019; 14:e0217648. [PMID: 31141556 PMCID: PMC6541277 DOI: 10.1371/journal.pone.0217648] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/15/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Family carers are an important source of care for older people. Although several studies have reported that subjective caregiver burden is related to depressive symptoms there are no systematic reviews quantifying this association. OBJECTIVE To establish the extent to which subjective caregiver burden is associated with depressive symptoms and whether this association would vary by study or care characteristics. METHODS We searched major databases such as PubMed, CINAHL, PsycINFO, Scopus and ISI Proceedings up to March 2018, and conducted a meta-analysis of included studies. Summary estimates of the association were obtained using a random-effects model to improve generalisation of findings. RESULTS After screening of 4,688 articles, 55 studies were included providing a total of 56 independent comparisons with a total of 9,847 carers from data across 20 countries. There was a large, positive association between subjective caregiver burden and depressive symptoms ([Formula: see text] = 0.514; 95% CI = 0.486, 0.541), with very low heterogeneity amongst individual studies (I2 = 8.6%). Sensitivity analyses showed no differences between cross-sectional or repeated measures ([Formula: see text] = 0.521; 95% CI = 0.491, 0.550; 51 samples) and longitudinal studies ([Formula: see text] = 0.454; 95% CI = 0.398, 0.508; 6 samples). We found a higher effect size for those caring for people living with dementia compared to those caring for frail older people, and stroke survivors. Carer sex, age and kinship did not change the estimate of the effect. CONCLUSIONS Subjective caregiver burden is a significant risk factor for depressive symptoms in carers of older people and may precipitate clinical depression. Those caring for people with dementia experience greater burden. There is a need for longitudinal evaluations examining the effects of potential mediators of the association of subjective burden and depressive symptoms. Future interventions should test whether minimizing subjective burden may modify the risk of developing depression in carers of older relatives.
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Affiliation(s)
| | | | | | - Vasiliki Orgeta
- Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
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